Fetal Sex Testing Won’t Fix India’s Daughter Shortage

India (WOMENSENEWS)—The minister for women and child welfare, Maneka Gandhi, stirred a huge controversy when she suggested about a month ago that sex determination tests should be performed on every fetus, as a method of battling the practice of female feticide.

The minister (the same one who recently said marital rape is not a concept that makes sense in India) has since tabled the idea, which is good because as the outcry shows this is not a problem with any quick fixes. It taps into an issue that has been simmering in India for a long time.

In 1994 the government outlawed prenatal sex determination tests so it is illegal for a doctor or clinic to disclose the sex of an unborn child to the family. However, two things continue to fuel these tests. First there is the availability of mobile ultrasound facilities in recent decades, even in rural areas. Second is the 1971 law legalizing abortion, which gives parents who want to avoid having a daughter the incentive to find out the sex of their fetus. Both have contributed to the practice of female feticide, since old structures of patriarchy that denigrate daughters remain strong.

You see this denigration loud and clear in the steady decline in the number of females per 1,000 males. That number fell to 942 in 2015 from 983 in 1951, according to 2011 Census data and the National Family Health Survey of 2015-16. The child sex ratio (0-6 years) has fallen even more alarmingly, to 918. That is one of the worst in the world, with some states such as Haryana recording a dismal 861.

The traditional belief is that families need sons for all sorts of reasons. Carrying on the family name is just the beginning. Since there is no old-age pension or social security system here, sons are expected to look after parents in their old age. Tradition forbids parents to live with their married daughters, it is considered shameful.

Sons are also needed to perform funeral rites for parents, since women are not allowed to light the funeral pyre.

Until two or three generations ago, if the first two offspring were daughters, parents just kept trying and had many children until they got son. But in the last six decades since independence, increasing education, modernization, availability of contraceptives and awareness of population pressures has lowered the birth rate. Today it is between two and three children per couple, about half what it was in 1947.

The advent of sex-determination technology meant that for several decades couples aborted female fetuses to ensure that at least one of two offspring would be a son.

Negative Consequences

Dr. Latha Venkatram, a gynecologist who practices in Bangalore, pointed out that as long as this kind of strong son preference persists, sex determination testing could lead to all sorts of negative consequences. For one thing, pregnant women may not register or reveal a pregnancy. That in turn could mean they lose much needed medical monitoring for safe deliveries. A third of all pregnant women in India are anemic, according to recent surveys.

Although the percentage of institutional deliveries has gradually risen, mandatory testing for the sex of the fetus could also bring a return to home deliveries, to avoid detection, with a resultant rise in maternal deaths due to complications.

It could also mean that women (or more crucially, their husbands or mothers-in-law, who often make family decisions, especially in rural areas) will turn to quacks instead of seeking medical services in hospitals.

Sex selection is a $100 million business, all underground and through mobile units since the outlawing of sex-selective abortions more than two decades ago. Over 850,000 illegal sex-selective abortions are estimated to be carried out in India annually, according to the Population Research Institute.

Vimochana, a leading women’s rights group in Bangalore, has pointed to the unrealistic aspect of the proposal since the government is still unable to ensure that pregnant women who go to local clinics get such routine care as iron and calcium supplements. “In that light, isn’t it farfetched to expect the government to accurately track female births or feticides?” said Dr. Shubha Badami, a pediatrician, during a group discussion among gynecologists here.

One gynecologist, who asked not to be named, said that addressing the persistent dowry custom that requires families to pay huge sums to marry their daughter off would be the best way to protect female fetuses.

Even though dowries were prohibited in 1964, the practice is still so widespread that in many communities the birth of a daughter still spells financial ruin, especially among middle- and lower-income families.

Badami, who is based in Bangalore, lists many worrisome scenarios with any mandate for a pregnant woman to undergo sex-determination testing. In one, unregistered pregnant mothers could wait too long to seek help with complications when abortions are attempted in unsafe and illegal institutions. (While abortion is legal in India some institutions and circumstances are not allowed.)

Infringing on Privacy

Making sex determination compulsory also infringes on the right to privacy and doctor-patient confidentiality, said Badami, also a personal friend, who spoke about the situation in a series of conversations, many of which took place at my home.

If a patient and her family are bent on getting rid of a female fetus, they will find a way, Badami added.

A woman carrying a female fetus the family does not want could be subject to mental and physical abuse for nine months; neglected, not fed, ostracized.

A spate of angry letters from readers, published in mainstream papers along with leader comments, have questioned the logic behind the minister’s suggestion, pointing out that a woman who doesn’t want children has a legal and legitimate right to terminate a pregnancy, no matter the sex of the fetus.

Until society addresses the issue of the status of women through education, no technical fixes to the problem will help. Since women are often blamed for producing an unwanted daughter, a good place to start is an awareness campaign about how the male chromosome determines the sex of the child.

Venkatram, the gynecologist, believes India’s high maternal mortality rate, currently 167 per 100,000 live births (compared to single digit figures for the U.S. and Japan), could rise if families avoid going to the clinic for fear of official monitoring of female fetuses.

And what about genuine cases where a woman miscarries, or needs an abortion on medical grounds? What happens to her? The slippery slope to punishing a woman for not carrying a pregnancy to term is all too easy to imagine.

A skewed sex ratio creates social problems in places such as Haryana, a prosperous northern state with per capita incomes higher than the national average. There, a scarcity of eligible girls for marriage has spurred men to choose brides from the south. Since language, food and customs vary by region, this has caused culture shock in the uprooted brides. Many brides are attracted by the higher income levels in these states but pay a high price in the form of cultural alienation.

Skewed sex ratios can also lead to polyandry, or a woman being required to service more than one man, especially brother-in-laws, because there aren’t enough eligible brides available.

But, experts believe, making sex-determination tests compulsory to ensure that female fetuses are not aborted is not the right approach. It could in fact worsen the problem.